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Obstetric guideline

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https://www.readbyqxmd.com/read/28238320/-oxytocin-administration-during-spontaneous-labour-guidelines-for-clinical-practice-guidelines-short-text
#1
C Dupont, M Carayol, C Le Ray, C Barasinski, R Beranger, A Burguet, A Chantry, C Chiesa, B Coulm, A Evrard, C Fischer, L Gaucher, C Guillou, F Leroy, E Phan, A Rousseau, V Tessier, F Vendittelli, C Deneux-Tharaux, D Riethmuller
OBJECTIVES: To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. METHOD: A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. RESULTS: The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5cm of cervical dilatation...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28237510/retrospective-evaluation-of-a-national-guideline-to-prevent-neonatal-hypoglycemia
#2
Annett Helleskov Rasmussen, Sonja Wehberg, Jesper Fenger-Groen, Henrik Thybo Christesen
BACKGROUND: Hypoglycemia is common in neonates and may cause adverse neurological outcomes. Guidelines should aim to prevent repeated hypoglycemic episodes in risk groups, but they are not usually stratified according to the severity of hypoglycemia risk, which may lead to inappropriate and redundant interventions. We evaluated the effect of a national prevention guideline stratified according to mild, moderate, and severe risks of hypoglycemia. METHODS: From national registers, a population cohort of 22,725 neonates was identified retrospectively before and after implementation of a national guideline...
January 24, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28227711/detection-of-fetal-kicks-using-body-worn-accelerometers-during-pregnancy-trade-offs-between-sensors-number-and-positioning
#3
Marco Altini, Patrick Mullan, Michiel Rooijakkers, Stefan Gradl, Julien Penders, Nele Geusens, Lars Grieten, Bjoern Eskofier, Marco Altini, Patrick Mullan, Michiel Rooijakkers, Stefan Gradl, Julien Penders, Nele Geusens, Lars Grieten, Bjoern Eskofier, Julien Penders, Michiel Rooijakkers, Nele Geusens, Stefan Gradl, Patrick Mullan, Lars Grieten, Bjoern Eskofier, Marco Altini
Monitoring fetal wellbeing is key in modern obstetrics. While fetal movement is routinely used as a proxy to fetal wellbeing, accurate, noninvasive, long-term monitoring of fetal movement is challenging. A few accelerometer-based systems have been developed in the past few years, to tackle common issues in ultrasound measurement and enable remote, self-administrated monitoring of fetal movement during pregnancy. However, many questions remain unanswered to date on the optimal setup in terms of body-worn accelerometers as well as signal processing and machine learning techniques used to detect fetal movement...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28212182/what-s-new-in-obstetric-anesthesia-the-2016-gerard-w-ostheimer-lecture
#4
Philip E Hess
This special article presents potentially important trends and issues affecting the field of obstetric anesthesia drawn from publications in 2015. Both maternal mortality and morbidity in the United States have increased in recent years because, in part, of the changing demographics of the childbearing population. Pregnant women are older and have more pre-existing conditions and complex medical histories. Cardiovascular and noncardiovascular medical diseases now account for half of maternal deaths in the United States...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28188771/twin-vaginal-delivery-innovate-or-abdicate
#5
REVIEW
Sarah Rae Easter, Laura Taouk, Jay Schulkin, Julian N Robinson
Neonatal safety data along with national guidelines have prompted renewed interest in vaginal delivery of twins-particularly in the case of the noncephalic second twin. Yet the rising rate of twin cesarean deliveries, coupled with the national decline in operative obstetrics, raise concerns about the availability of providers skilled in twin vaginal birth. Providers are key stakeholders for increasing rates of twin vaginal delivery. We surveyed a group of practicing obstetricians to explore potential barriers to vaginal birth of twins with a focus on delivery of the noncephalic second twin...
February 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28179485/variation-in-sepsis-evaluation-across-a-national-network-of-nurseries
#6
Sagori Mukhopadhyay, James A Taylor, Isabelle Von Kohorn, Valerie Flaherman, Anthony E Burgos, Carrie A Phillipi, Nui Dhepyasuwan, Elizabeth King, Miren Dhudasia, Karen M Puopolo
BACKGROUND AND OBJECTIVES: The extent to which clinicians use currently available guidelines for early-onset sepsis (EOS) screening has not been described. The Better Outcomes through Research for Newborns network represents 97 nurseries in 34 states across the United States. The objective of this study was to describe EOS risk management strategies across a national sample of newborn nurseries. METHODS: A Web-based survey was sent to each Better Outcomes through Research for Newborns network nursery site representative...
February 8, 2017: Pediatrics
https://www.readbyqxmd.com/read/28176919/management-of-obstetric-postpartum-hemorrhage-a-national-service-evaluation-of-current-practice-in-the-uk
#7
Bassel H Al Wattar, Jennifer A Tamblyn, William Parry-Smith, Mathew Prior, Helen Van Der Nelson
BACKGROUND: Postpartum hemorrhage (PPH) continues to be one of the major causes of maternal mortality and morbidity in obstetrics. Variations in practice often lead to adverse maternity outcomes following PPH. Our objective was to assess the current practice in managing PPH in the UK. METHODS: We performed a national multicenter prospective service evaluation study over one calendar month and compared the current performance to national standards for managing PPH...
2017: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/28164291/surgical-or-medical-interventions-for-female-genital-mutilation
#8
Helen Smith, Karin Stein
Deinfibulation can prevent or treat gynecological and obstetric complications in women living with type III female genital mutilation (FGM), and subsequently improve childbirth outcomes. Recently published WHO guidelines recommend use of deinfibulation in both circumstances. However, to really impact practice, evidence-based guidance needs to be matched with evidence-based implementation strategies. This qualitative evidence synthesis provides information on the factors that facilitate or act as barriers to use of deinfibulation, and the context and conditions that are necessary for implementing the procedure, including healthcare providers' knowledge and experience, the service delivery environment, as well as broader health system contexts...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28163088/risk-of-luteal-phase-pregnancy-with-any-cycle-day-initiation-of-subdermal-contraceptive-implants
#9
Molly Richards, Stephanie B Teal, Jeanelle Sheeder
OBJECTIVES: To determine rates of luteal phase pregnancy (LPP) in young women initiating subdermal implants on any day of the menstrual cycle. STUDY DESIGN: We assessed a retrospective cohort of young women receiving contraceptive implants at an adolescent Title-X clinic. Patients with negative pregnancy tests were eligible for same-day insertion, regardless of cycle day, contraceptive use, or last intercourse. We computed LPP rates for those within manufacturer guidelines for insertion (≤5 days of menstrual onset or ≤7 days post-discontinuing hormonal contraception) and outside these guidelines...
February 2, 2017: Contraception
https://www.readbyqxmd.com/read/28162191/-the-chinese-expert-consensus-on-clinical-practice-of-medically-unexplained-symptoms
#10
(no author information available yet)
"Medically unexplained symptoms" (MUS) are commonly seen in all clinical specialties. The preliminary investigations in China show a prevalence of MUS in 4.15%-18.2% of clinical patients. Based on international and national guidelines and the most advanced studies, a Chinese expert consensus on clinical practice of MUS is reached through three rounds of discussion seminars by 25 experts from various specialties including psychiatry, internal medicine, surgery, gynecology-obstetrics, otorhinolar-yngology and traditional Chinese medicine...
February 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28153744/thyroid-stimulating-hormone-tsh-%C3%A2-2-5mu-l-in-early-pregnancy-prevalence-and-subsequent-outcomes
#11
David M Carty, Flora Doogan, Paul Welsh, Anna F Dominiczak, Christian Delles
OBJECTIVE: There remains controversy over how women with abnormal thyroid function tests in pregnancy should be classified. In this study we assessed the proportion of women with thyroid stimulating hormone (TSH)≥2.5mU/l in a large obstetric cohort, and examined how many have gone on to develop thyroid disease in the years since their pregnancy. STUDY DESIGN: 4643 women were recruited and samples taken in early pregnancy between 2007 and 2010. Thyroid function tests were analysed in 2014; in women with raised TSH computerised health records and prescription databases were used to identify thyroid disease detected since pregnancy...
January 25, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28153653/prenatal-diagnosis-and-management-of-vasa-previa-in-twin-pregnancies-a-case-series-and-systematic-review
#12
REVIEW
Eric Jauniaux, Yaakov Melcer, Ron Maymon
BACKGROUND: Twin pregnancies are at higher risks of velamentous cord insertion (VCI) and vasa previa. In-vitro fertilization (IVF) is an additional risk factor of abnormal cord insertion and thus the incidence of vasa previa is likely to increase over the next decades. OBJECTIVE: To evaluate the role of ultrasound imaging in optimizing the management of twins diagnosed with vasa previa antenatally. STUDY DESIGN: We searched our database for twin pregnancies diagnosed with vasa previa and managed antenatally using measurements of cervical length (CL) and performed a systematic review of articles which correlated prenatal diagnosis of vasa previa in twins and pregnancy outcome...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28137527/use-of-herbal-product-among-pregnant-women-in-turkey
#13
Aygül Kıssal, Ümran Çevik Güner, Döndü Batkın Ertürk
OBJECTIVE: This study was conducted to determine the herbal product use of pregnants as there is not adequate information relating to the rate of herbal product use during pregnancy in Turkey and what is thought about effects and side effects thereof. METHODS: It is a descriptive study consisted of 366 pregnants admitted to hospital for childbirth in gynaecology and obstetrics clinics of a public hospital or a university hospital. Data were collected with individual information form and question form of herbal product use in pregnancy...
February 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28134395/ultrasound-examination-of-the-fetal-heart
#14
Katherine C Bishop, Jeffrey A Kuller, Brita K Boyd, Eleanor H Rhee, Stephen Miller, Piers Barker
Congenital heart disease (CHD) occurs in 4-13 per 1000 births in the United States. While many risk factors for CHD have been identified, more than 90% of cases occur in low-risk patients. Guidelines for fetal cardiac screening during the second trimester anatomy ultrasound have been developed by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) in order to improve antenatal detection rates and to standardize the fetal cardiac screening examination. Patients found to be at increased risk of CHD because of risk factors or an abnormal screening examination should be referred for second trimester fetal echocardiography...
January 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28132168/delivery-and-payment-redesign-to-reduce-disparities-in-high-risk-postpartum-care
#15
Elizabeth A Howell, Norma A Padrón, Susan J Beane, Joanne Stone, Virginia Walther, Amy Balbierz, Rashi Kumar, José A Pagán
Purpose This paper describes the implementation of an innovative program that aims to improve postpartum care through a set of coordinated delivery and payment system changes designed to use postpartum care as an opportunity to impact the current and future health of vulnerable women and reduce disparities in health outcomes among minority women. Description A large health care system, a Medicaid managed care organization, and a multidisciplinary team of experts in obstetrics, health economics, and health disparities designed an intervention to improve postpartum care for women identified as high-risk...
January 28, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28132014/obstetrical-brachial-plexus-injury-obpi-canada-s-national-clinical-practice-guideline
#16
Christopher J Coroneos, Sophocles H Voineskos, Marie K Christakis, Achilleas Thoma, James R Bain, Melissa C Brouwers
OBJECTIVE: The objective of this study was to establish an evidence-based clinical practice guideline for the primary management of obstetrical brachial plexus injury (OBPI). This clinical practice guideline addresses 4 existing gaps: (1) historic poor use of evidence, (2) timing of referral to multidisciplinary care, (3) Indications and timing of operative nerve repair and (4) distribution of expertise. SETTING: The guideline is intended for all healthcare providers treating infants and children, and all specialists treating upper extremity injuries...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28121757/the-perinatal-birth-environment-communication-strategies-and-processes-for-adherence-to-a-standardized-guideline-in-women-undergoing-second-stage-labor-with-epidural-anesthesia
#17
Samantha A Sommerness, Rebecca Gams, Phillip N Rauk, Ananta Bangdiwala, Daniel V Landers, Melissa D Avery, Charles Hirt, Kristi Miller, Amy Millar, Suzin Cho, Andrea Shields
Key to any perinatal safety initiative is buy-in and strong leadership from obstetric and pediatric providers, advanced practice nurses, and labor and delivery nurses in collaboration with ancillary staff. In the fall of 2007, executives of a large Midwestern hospital system created the Zero Birth Injury Initiative. This multidisciplinary group sought to eliminate birth injury using the Institute of Healthcare Improvement Perinatal Bundles. Concurrently, the team implemented a standardized second-stage labor guideline for women who choose epidural analgesia for pain management to continue the work of eliminating birth injuries in second-stage labor...
January 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28110176/the-management-of-hiv-in-pregnancy-a-10-year-experience
#18
Sonia F Raffe, Charlotte Savage, Louisa A Perry, Amie Patel, Tricia Keith, Richard Howell, Robert Bradley, Rob Bomont, Katy Fidler, Yvonne Gilleece
OBJECTIVE: The package of care to reduce HIV mother to child transmission (MTCT) has evolved significantly since trials of ante and intrapartum antiretroviral therapy (ART) in 1994. In the UK MTCT rate has fallen from 25.6% in the 1990s to 0.46%. We review the management of HIV in pregnancy in Brighton in the context of evolving guidelines. STUDY DESIGN: HIV, obstetric and neonatal notes of all HIV positive women, pregnant between 2003 and 2014, were reviewed. RESULTS: 97 pregnancies in 75 women were identified, resulting in 79 live births...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28099701/a-systematic-review-of-implementation-strategies-to-deliver-guidelines-on-obstetric-care-practice-in-low-and-middle-income-countries
#19
REVIEW
Mari Imamura, Lovney Kanguru, Suzanne Penfold, Tim Stokes, Janette Camosso-Stefinovic, Beth Shaw, Julia Hussein
BACKGROUND: Healthcare measures to prevent maternal deaths are well known. However, effective implementation of this knowledge to change practice remains a challenge. OBJECTIVES: To assess whether strategies to promote the use of guidelines can improve obstetric practices in low- and middle-income countries (LMICs). SEARCH STRATEGY: Electronic databases were searched up to February 7, 2014, using relevant terms for implementation strategies (e...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28090643/the-use-of-instructional-design-guidelines-to-increase-effectiveness-of-postpartum-hemorrhage-simulation-training
#20
Brena C P de Melo, Ana R Falbo, Arno M M Muijtjens, Cees P M van der Vleuten, Jeroen J G van Merriënboer
OBJECTIVE: To compare learning outcomes of postpartum hemorrhage simulation training based on either instructional design guidelines or best practice. METHODS: A pretest-post-test non-equivalent groups study was conducted among obstetrics and gynecology residents in Recife, Brazil, from June 8 to August 30, 2013. The instructional design group included 13 teams, whereas the best practice group included seven teams. A standardized task checklist was used for scenario analysis and the proportion of correctly executed tasks compared (post-test minus pretest)...
December 16, 2016: International Journal of Gynaecology and Obstetrics
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